Abstract: The military emergency tourniquet is a device for rapidly and easily reducing or stopping blood flow to a limb. The tourniquet utilizes a closed loop system and includes a twistable strap, a base including two opposing entry apertures and an exit aperture, a windlass and at least one receiving loop. The twistable strap is slidably positioned through the opposing entry apertures and the exit aperture thereby forming a closed loop. The windlass is positioned outside of the closed loop and is affixed to one end of the strap. The windlass includes an aperture capable of sliding the opposing end of the strap therethrough. The receiving loop receives an end of the windlass and is affixed to the base.

Abstract: A tourniquet assembly includes a strap and a windlass crank attached to a windlass cord that forms a loop that is slidably engaged with anchors that are attached to the main strap. During use, the crank is rotated, causing the windlass cord to twist. This effectively shortens the length of the windlass cord which also pulls the anchors inwardly, thereby causing a similar shortening of the main strap between the anchors and enabling the strap to be used for use as a tourniquet.

Abstract: A tourniquet band is made of an elastic material and has a plush surace on one side and a series of hook fastener material patches on the reverse side. The woven structure includes a series of parallel elastic threads covered by a dense yet loosely coiled bundle of non-elastic threads. The non-elastic threads are oriented to form the plush surface while allowing the elastic core thread to elongate for applying pressure to a body part by elastic compression when the tourniquet is wrapped around the body part and secured by joining the hook material with the plush surface.

Abstract: The present invention relates generally to first aid articles and more specifically tourniquets. One embodiment of the claimed subject matter includes a tourniquet article having a substantially rigid base. A handle is provided, the handle has first and second ends and a slot disposed between the first and second ends. A strap disposed adjacent to the substantially rigid base and passes through the slot of the handle. A structural member having first and second sides is attached to the base at least at first and second points along each of the first and second sides of the base such that the strap being sandwiched between at least a portion of the structural member and said base.

Abstract: Methods and apparatus for applying focused pressure to a target vessel to dilate the target vessel for hemodialysis.

Abstract: Wound closure apparatus is provided including a body having an elongated, lowermost force-transmitting surface operable to be placed in a proximal, external, wound-closing position on a patient, together with a force-exerting assembly coupled with the body and operable to exert a downwardly directed force serving to generate wound-closing pressure against the patient's tissue. The force-transmitting surface is preferably three-dimensionally asymmetric so that forces of different magnitude are exerted at different locations along the length of the surface. The apparatus is especially designed for the closure of wounds attendant to endovascular interventions, e.g., a femoral artery puncture wound incident to percutaneous cardiac intervention (PCI), and is capable of quickly effecting wound closure with a time-to-ambulation (TTA) of approximately 60 minutes, and with a very low complication rate.

Abstract: A tourniquet with a generally hexagonally shaped upper frame. The upper frame has a linear upper frame elements meeting at an upper apex. Linear side frame elements meet a linear upper frame element at an upper side apex. Linear lower frame elements meets one side linear side frame element at a lower side apex wherein the linear lower frame elements extend beyond an overlapping apex. Each linear lower frame element of said linear lower frame elements comprises a terminus with a handle attached to each terminus.

Abstract: The present invention relates to a compression arrangement (1) adapted to be arranged around a patient's forearm (9) to provide pressure to an artery puncture site (10). The compression arrangement (1) comprises, a ventral part (3), adapted to be arranged at the ventral side (12) of the forearm (9), a dorsal part (4), adapted to be arranged at the dorsal side (18) of the forearm (9), an attachment band (2), and a compression element (5) in the shape of an inflatable bladder, adapted to provide pressure to the artery puncture site (10) when the compression element (5) is inflated. The ventral part (3) comprises a compression element part (6) where the compression element (5) is arranged, and the ventral part (3) is essentially rigid and has a predetermined shape adapted to the anatomy of the forearm (9).

Abstract: Tourniquet devices and associated methods of use and manufacture are disclosed herein. Tourniquet devices configured in accordance with several embodiments of the disclosure can include, for example, a strap having a proximal end portion and a distal end portion, a buckle assembly connected to the proximal end portion, and a pulley assembly movably coupled to the strap. Tourniquet devices configured in accordance with the technology can be easily applied because the pulley assemblies can reduce the force a user must exert on the tourniquet devices to constrict or occlude blood flow. Additionally, tourniquet devices disclosed herein can also serve as functional, wearable items (e.g., a belt, integrated into clothing) such that the tourniquet devices are conveniently stored and readily accessible in emergencies.

Abstract: The invention relates to a device capable of stopping the bleeding caused by the withdrawal of an injector stuck into an injection area of a patient. The device comprises: a base; a supporting means capable of temporarily attaching the base to the patient; an applicator supported by the base and provided with a transparent pad; and a screw-and-nut adjustment means capable of moving the applicator toward the injection area so that the applicator moves to a position where the pad exerts pressure on the injection area. The screw-and-nut system is located completely outside the diameter of the transparent pad. The invention can be used for angiography and angioplasty operations.

Abstract: Tactical pants can include one or more features for retaining a utility object, such as a firearm, for protecting against ballistic projectiles, or for reducing the effects of leg wounds. Various pants can include one or more of a weight distribution system, an anti-ballistic shield, or one or more tourniquets.

Abstract: Systems and methods of applying a bandage to a patient including securing a bandage device over a wound and around a body part of the patient. The bandage device includes a platform with a plurality of first openings for use with a tensioning mechanism, and at least one second opening for use with a pressure adjusting mechanism. The pressure adjusting mechanism may include threads, detents, and other adjustable, or semi-permanent, locking mechanisms. In addition to pressure applied to a wound via the tensioning mechanism, an additional pressure may be applied to the wound through the platform of the bandage device via the pressure adjusting mechanism. The pressure adjusting mechanism may have a pressure application mechanism that applies the additional pressure to the wound.

Abstract: A timer for tourniquet, adapted for application in a surgery, emergency or military situations to stop arterial blood loss in an injured limb, which is optionally activated by use of the tourniquet and/or optionally provided in association with a monitor for a plurality of tourniquets.

Abstract: A low-cost disposable tourniquet cuff includes: a first sheet formed of flexible material that is impermeable to gas; a second sheet facing the first sheet and formed of flexible material impermeable to gas; a bladder seal joining the first sheet to the second sheet around a perimeter to form an inflatable bladder within the perimeter; port means communicating pneumatically with the bladder and releasably connectable to a tourniquet instrument; stiffener means contained within the inflatable bladder and formed of gas-impermeable material less flexible than the first sheet, wherein the stiffener means has a stiffener width dimension less than the bladder width dimension and is joined to the first sheet to form a non-inflatable portion of the first sheet; and securing means attached to the non-inflatable portion of the first sheet and adapted to allow a surgical user to releasably secure the cuff around the limb at the desired location so that the bladder overlaps upon itself.

Abstract: Tourniquet assemblies are provided including a pressure applicator adapted to be secured around a limb and a tensioning mechanism for applying a working tension to the pressure applicator. The tensioning mechanism may include a platform, a clip and a tensioning member. The tensioning mechanism may be configured to apply the working tension via rotation of the tensioning member, and the clip may be configured to receive, and at least temporarily inhibit rotation of, the tensioning member. A tension indicator may also be provided including a base configured to attach to a tourniquet strap, a platform configured to move relative to the base when subjected to a tourniquet working pressure, and one or more tactile or visual indicators configured to provide a variable tactile or visual indicator based on the tourniquet working pressure.

Abstract: Low-cost tourniquet cuff apparatus includes: an inflatable bladder formed of flexible material having a bladder width dimension when the bladder is uninflated and a having a bladder length dimension sufficient for encircling a limb of a surgical patient at a desired location on the limb and for overlapping upon itself, wherein the bladder includes a bladder first inner surface facing a bladder second inner surface along the bladder length dimension and across the bladder width dimension when the bladder is uninflated; securing means for securing the overlapping bladder around the limb at the desired location; port means communicating pneumatically with the inflatable bladder and releasably connectable to a tourniquet instrument for supplying the bladder with pressurized gas; and stiffener means having a predetermined stiffness and having a stiffener width dimension less than the bladder width dimension, wherein the stiffener means is non-releasably attached to the bladder first inner surface within the inflat

Abstract: An adjustable vascular compression device assists in achieving partial or full occlusion of a blood vessel when applied to a patient's limb, for example, during or following a medical procedure. Pads on the device apply preferential compression to portions of the circumference of the limb so as to enable blood flow through adjacent blood vessels during the compression period. Further, rapid fastening, tightening, loosening and release is enabled by a single mechanism, and gradual adjustments to the tightness may be made without releasing said mechanism.

Abstract: A medical dressing for chest wounds, including a one-way valve that can be covered so as to protect against intrusion of airborne contaminants and to prevent passage of fluids in either direction, and including indicia visible using night vision devices but not visible in visible light to the naked eye in some embodiments. The indicia visible using night vision devices may be included in other medical apparatus, as well, so that the medical dressings or other apparatus can be used effectively during darkness, in combat situations, without being seen by enemy combatants not equipped with night vision devices.

Abstract: A constructed padding for use with a tourniquet, kits, and methods of its use are provided. In use, the tourniquet padding is wrapped about and secured to an extremity, and a tourniquet is positioned onto the tourniquet padding. The construction of the tourniquet padding prevents a tourniquet, blood pressure cuff, etc., from slipping out of position during use.

Abstract: Apparatus for estimating a magnitude of leakage from a surgical tourniquet system while pressure in a cuff of the system is regulated near a reference pressure.

Abstract: The present invention relates generally to first aid articles and more specifically tourniquets suitable for one handed application. One embodiment of the invention is directed to a tourniquet having a base defining first and second ends. A constricting band is attached to and extends from the first end of the base. A handle is engaged with the constricting band. The constricting band engages a self cinching buckle which includes polygonal frame member and a self cinching member engaged with the polygonal frame member. A hook member is attached to the first end of the base and is configured to engage the polygonal frame member.

Abstract: A styptic device (10) for substantially hemostatically sealing a percutaneous puncture (12) in a blood vessel (14) of a patient (11), the styptic device (10) comprising: a base (16); a main compression element (18) extending from the base (16), the main compression element (18) defining a main compression surface (24) compressible against the patient (11); and an auxiliary compression element (20) removably attachable to the base (16), the auxiliary compression element (20) defining an auxiliary compression surface (26) compressible against the patient (11).

Abstract: A combination belt buckle and tourniquet includes a main body, a cover and a cover axle on which the main body and the cover are mounted so as to be rotatable relative to each other. When the combination is used as a tourniquet, webbing is fed between the main body and the cover, and the main body and the cover are rotated toward each other so as to form a pinching vice for capturing the webbing tightly therebetween.

Abstract: An adjustable tourniquet includes a first component, a second component, a third component and a band. Two ends of the first component respectively have an axle for fixing the band and a buckling trough with an engaging element, wherein two ends of the axle respectively have a ratchet. The first and second components respectively have a rejecting element and a driving element to stop the ratchet. The axle is clamped by an axial cover, and two ends of the axle are respectively connected with a connecting axle for penetrating the second component. Furthermore, the ratchet includes an inner and an outer ratchet surfaces respectively for butting the rejecting element and the driving element, and the teeth of the inner and outer ratchet surfaces are respectively bent toward the same direction and the arrangement of the inner and outer ratchet surfaces are perpendicular to each other.

Abstract: The subject matter of the invention is a wound care article exhibiting a quantity of super-absorbent polymers. The wound care article is characterized in that characterized in that it exhibits at least one agent which can restrict the bleeding or the tendency to bleed. In the process it can be a chemically and/or pharmacologically and/or physiologically acting active ingredient or active ingredient complex.

Abstract: A tourniquet system embedded within the garment, the tourniquet system including a band, an optional bar, and an anti-pinch plate. The bar comprises an elongate portion of material having a first end portion, an intermediate portion, and a second end portion, at least one aperture formed in the bar so as to accept the band and allow the band to pass therethrough, at least one locking protrusion that extends from at least one of the first end portion or the second end portion. The anti-pinch plate includes one or more band receiving apertures formed so as to accept the band and allow the band to pass therethrough, wherein the anti-pinch plate includes one or more locking notches formed substantially along an edge portion of the anti-pinch plate, wherein the locking notches provide a means for securing at least a portion of the bar to the anti-pinch plate.

Abstract: An adaptive surgical tourniquet comprises: an inflatable cuff for encircling a limb of a patient; pressurizing means for pressurizing the cuff; pressure relief means for depressurizing the cuff; cuff pressure sensing means for sensing cuff pressure; limb occlusion pressure sensing means for sensing the patient's initial limb occlusion pressure at a selected time; physiologic characteristic sensing means for sensing a physiologic characteristic of the patient; and pressure regulator means for establishing an adapted limb occlusion pressure that is a predetermined function of the initial limb occlusion pressure and the physiologic characteristic, wherein the pressure regulator means is operable after the initial limb occlusion pressure is sensed for selectably activating the pressurizing means and the pressure relief means to maintain the cuff pressure above the adapted limb occlusion pressure for a time period suitably long for the performance of a surgical procedure.

Abstract: An auto-release tourniquet apparatus has a strap, a housing having a first slot therein suitable for receiving a first end of the strap and a second slot suitable for receiving another portion of the strap therein, and a strap releasing mechanism positioned in the housing. The strap releasing mechanism serves to release at least one of the first and second ends of the strap from the housing after a predetermined period of time. A solenoid is positioned in the housing and acts upon the first end of the strap so as to allow for the ejection of the first end of the strap from the first slot after the predetermined period of time. A strap tensioning mechanism is associated with the second slot of the housing for allowing the strap to be suitably tensioned.

Abstract: An apparatus and method for determining proper endotreachal placement is disclosed. The apparatus includes an audio receiver having a body, a microphone mount in a center thereof the body and an audio cavity, an audio processing unit; and a signal cable connected at a first end to the microphone and at a second end, where the receiver is adapted to be positioned in a suprasternal notch of a patient and the acoustic signal detected after inflation of a balloon associated with an endotracheal tube. The method uses the apparatus to detect and analyze an audio signal. The audio signal is then used to confirm endotracheal tube placement.

Abstract: The present invention concerns a surgical ring, configured to be implanted around a biological organ having a pouch or a duct shape. A surgical ring according to the present invention forms a closed loop around the organ, altering its diameter. Variations in ring diameter are reversibly controlled by a system that, in one embodiment, includes a flexible filiform element slidably disposed within the body of the ring and coupled to a first extremity of the ring and also to an actuator disposed near a second extremity of the ring.

Abstract: The present invention relates generally to first aid articles and more specifically tourniquets. One embodiment of the claimed subject matter includes a tourniquet article having a substantially rigid base. A handle is provided, the handle has first and second ends and a slot disposed between the first and second ends. A strap disposed adjacent to the substantially rigid base and passes through the slot of the handle. A structural member having first and second sides is attached to the base at least at first and second points along each of the first and second sides of the base such that the strap being sandwiched between at least a portion of the structural member and said base.

Abstract: The invention provides an article of clothing having a tourniquet affixed to the clothing at one end of the tourniquet, the tourniquet comprising a band comprised of an elastic and flexible material, the band having a width and a length, a first end and a second end, and a first face and second face, where at least a portion of the first face comprises hook-type fastener means, and where the second face comprises loop-type fastener means.

Abstract: An embodiment is a tourniquet including a constricting band with an angled constriction tightening point to substantially prevent skin from being caught in the constriction action. The angled constriction tightening point may further enable the tourniquet to substantially securely couple to web gear, for example to pouch attachment ladder system (PALS) webbing of modular lightweight load-carrying equipment (MOLLE) systems.

Abstract: An apparatus for treatment of external hemorrhaging has a panel for applying pressure to an absorbent pad and a wound on a body part. The panel has a central portion located between first and second arms which extend outwardly and in transversely opposed directions from the central portion. The apparatus includes a strap which is attached to the first arm at or near first strap end, and is releasably attachable to the second arm at an attachment region of the strap spaced apart from the first strap end. When the panel is strapped to the body part, the tension in the strap pulls on and elastically deforms the first and second arms of the panel inwardly toward the body part, and applies localized pressure to the pad and wound.

Abstract: A ratcheting tourniquet apparatus having a quick adjustment mechanism for initial tourniquet strap approximation, and a ratcheting assembly for fine, stringent strap adjustment about a limb of a patient. The apparatus provides for quick and easy use, even to the uninitiated. The apparatus provides for sufficient leverage via the ratcheting assembly such that severe tightening of the strap is possible as needed. The apparatus quick adjustment mechanism further provides instant tourniquet release.

Abstract: An improved treatment apparatus and method of using in which the device has plural protruding contact elements, each preferably having an undulating contact surface with one or more peaks. In one preferred embodiment, a plurality of contact elements are positioned spaced apart from one another in columns. In another device an elongated single column is provided. Mounting brackets are provided that enable a user to position the device easily and to adjust mounting straps and/or belts to a particular body shape. In one example, the device may include bracket apertures into which mounting brackets can be positioned. In another aspect of the invention, adjustable buckles and/or binders are provided can be used to adjust the length of the straps and secure the device to the wearer in use.

Abstract: A tourniquet for restricting a flow of blood in a body part is presented. In accordance with embodiments of the present invention, the tourniquet comprises a first elongated member, and a second elongated member in slidable engagement with the first elongated member. In addition, the tourniquet includes a tensioning mechanism connected to the second elongated member, wherein a compressive force is applied to the body part upon applying a tensile force to the second elongated member using the tensioning mechanism. The tourniquet is suited for emergency use, and may be applied by using only one hand. Thus, the tourniquet may be applied, manipulated and tightened by the wearer, even if the wearer is limited to the use of a single hand.

Abstract: Apparatus is provided for protecting a patient's limb from tourniquet-related injury, comprising: a tourniquet cuff having a length sufficient for encircling a limb protection sleeve applied to a limb at a location having a limb circumference of not less than a predetermined minimum limb circumference and not more than a predetermined maximum limb circumference; limb protection sleeve adapted for applying to the limb at the location, wherein the sleeve has a tubular shape and a tubular circumference predetermined to be less than the predetermined minimum and wherein the sleeve is formed to allow elastic stretching of the tubular shape sufficient to increase the tubular circumference to be substantially equivalent to the limb circumference at the location when the sleeve is applied to the limb, thereby applying a pressure to the limb that is greater than a predetermined minimum pressure and less than a predetermined maximum pressure; and identification means perceptible to a user for providing an indication to

Abstract: A tourniquet for restricting a flow of blood in a body part comprises a first elongated member, and a second elongated member in slidable engagement with the first elongated member. In addition, the tourniquet includes a tensioning mechanism connected to the second elongated member, wherein a compressive force is applied to the body part upon applying a tensile force to the second elongated member using the tensioning mechanism. At least one embodiment of the present invention comprises a buckle having one or more of a raised intermediate bar and one or more teeth for contacting a portion of the first elongated member. The tourniquet is suited for emergency use, and may be applied by using only one hand. Thus, the tourniquet may be applied, manipulated and tightened by the wearer, even if the wearer is limited to the use of a single hand.

Abstract: An identification system and method that enables third parties, such as uniformed police officers, to identify another authorized firearms bearer, in order reduce risk of misidentification of intent that might otherwise lead to an unfortunate accidental injury during an incident response. The system includes an identification tag that is selectively affixable to a firearm in a position visible to third parties. The identification tag is selectively affixed in a stored position that preferably is furled so that it does not interfere with firearms storage or usage. The tag is deployable in an extended position to increase potential recognition to third parties. The tag desirably may also be wearable by the firearms bearer, such as a wrist band, head band or sash.

Abstract: This invention presents a non-pneumatic tourniquet device designed for quick, easy application to an injured digit, such as a finger or a toe. One preferred embodiment comprises an frame, which is affixed to a flexible layer or membrane, and allows for an opening for the insertion of the injured digit through the device. This easy to use apparatus temporarily checks the bleeding or blood flow by applying an external pressure or a compression to the blood vessels in an appendage and also allows for exsanguination of the injured area.

Abstract: A device for applying pressure in progression to restrict the blood content of a limb, whereby at least an elastic tight sleeve is unfolded directionally on that limb towards the center of the body. The unfolding is streamlined using at least one auxiliary application strap. In certain embodiments a constricting toroid is used as a major restriction agent.

Abstract: A tourniquet includes a first and a second elements and a strap having one end winding around a human body and threading through the first element. The first element has a latch slot and a latch element. The second element has a coupling element at one end latchable with the latch element and the other end fastened to the strap. The first element has an upper and a lower cases and a brake unit inside. The upper and lower cases have respectively an upper and a lower openings threaded through by the strap. The brake unit has a detent edge at one end and an axle at the other end extended to form an actuating member movable with the brake unit about the axle, and an elastic element provides a force for the detent edge to butt the strap from the upper opening to the lower opening.

Abstract: An improved treatment apparatus and method of using in which the device has plural protruding contact elements, each preferably having an undulating contact surface with one or more peaks. In one preferred embodiment, a plurality of contact elements are positioned spaced apart from one another in columns. In another device an elongated single column is provided. Mounting brackets are provided that enable a user to position the device easily and to adjust mounting straps and/or belts to a particular body shape. In one example, the device may include bracket apertures into which mounting brackets can be positioned. In another aspect of the invention, adjustable buckles and/or binders are provided can be used to adjust the length of the straps and secure the device to the wearer in use.

Abstract: A tourniquet for restricting a flow of blood in a body part is presented. In accordance with embodiments of the present invention, the tourniquet comprises a first elongated member, and a second elongated member in slidable engagement with the first elongated member. In addition, the tourniquet includes a tensioning mechanism connected to the second elongated member, wherein a compressive force is applied to the body part upon applying a tensile force to the second elongated member using the tensioning mechanism. The tourniquet is suited for emergency use, and may be applied by using only one hand. Thus, the tourniquet may be applied, manipulated and tightened by the wearer, even if the wearer is limited to the use of a single hand.

Abstract: A tourniquet system including a band, an optional bar, and an anti-pinch plate. The bar comprises an elongate portion of material having a first end portion, an intermediate portion, and a second end portion, at least one aperture formed in the bar so as to accept the band and allow the band to pass therethrough, at least one locking protrusion that extends from at least one of the first end portion or the second end portion. The anti-pinch plate includes one or more band receiving apertures formed so as to accept the band and allow the band to pass therethrough, wherein the anti-pinch plate includes one or more locking notches formed substantially along an edge portion of the anti-pinch plate, wherein the locking notches provide a means for securing at least a portion of the bar to the anti-pinch plate.

Abstract: A radial artery compression device configured to be secured to a wrist or other portion of a patient to provide adjustable and consistent compression pressure in the area of a radial artery access site or other physiological portion of a patient to achieve hemostasis either during or after a medical procedure such as a percutaneous coronary procedure. The radial artery compression device includes a rotatable member and a compression pad adapted such that rotation of the rotatable member does not affect the rotational orientation of the compression pad. According to one embodiment of the present invention, a single rotation of the rotatable member results in complete extension or retraction of the radial artery compression device. According to another embodiment of the present invention, the rotation of the rotatable member results in a compounding of the extension or retraction of the compression pad relative to the body of the radial artery compression device.

Abstract: The invention relates to a gastroplasty ring formed by a flexible band (2) which comprises a first end part (5) and a second end part (6) and which is intended to be closed around the stomach toward its two end parts by a closure system in order to reduce the diameter of the opening of the stoma by forming a loop, the band comprising an adjustable-volume annular compression chamber (3) connected, at the first end part, by an adjusting catheter (7) to a device for adjusting the internal pressure of said chamber, so as to adjust its diametral expansion, the ring comprising at least one grab tab (11, 12, 13) which projects toward the outside of the loop to make it easier for the two end parts to be brought together and parted. Gastric implant for treating obesity.

Abstract: A low-cost contour cuff for surgical tourniquet systems comprises: a sheath containing an inflatable bladder, the sheath having an arcuate shape, an outer surface and a centerline equidistant between first and second side edges; a securing strap non-releasably attached to the outer surface and formed of substantially inextensible material having a shape that is predetermined and substantially flat, wherein the strap includes a bending portion near a first strap end and a fastening portion near a second strap end, and wherein the bending portion is adapted to allow twisting of the bending portion out of the substantially flat shape to facilitate positioning of the fastening portion into any of a plurality of positions in the substantially flat shape; and fastening means for releasably attaching the fastening portion of the securing strap to the outer surface whenever the sheath is curved into a position for surrounding a limb.

Abstract: A method of stopping a bleeding from a fistula situated on a limb of a patient for hemodialysis, includes: providing a tourniquet band having a blood-stopping protrusion projecting therefrom; encircling the limb of the patient with the tourniquet band to cover the fistula and pressing the fistula with the blood-stopping protrusion to stop the bleeding; connecting a sensor to the tourniquet band to sense a blood flow in the fistula and to generate a signal representative of the blood flow; and electrically connecting a notifying device to the sensor and using the notifying device to produce a notifying signal in response to the signal transmitted by the sensor.